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Abstract
We have demonstrated that PV in vertebral metastasis leads to substantial functional improvement in patients with expected survival of less than 6 months, with a very low rate of complications. In our opinion, PV should be included in the therapeutic arsenal for patients with a Tokuhashi score of 4 or less, with intractable pain from a spinal instability, where surgery is not considered. In patients with a Tokuhashi score of between 5 and 8, PV should be considered as an alternative to surgical stabilization. Patients with a neurological deficit can be effectively treated for pain relief with a PV, while radiotherapy allows a neurological recovery. Our study demonstrates that PV can be performed safely and effectively to achieve consolidation of collapsed vertebra, an alternative to the need for operative intervention in properly selected patient. Although this technique can be safely applied for treatment of spinal pain in patients with pathological vertebral collapse, it is challenging and requires a steep learning curve. The passage of the needle presents danger on the dura and the nerve root